【摘要】 目的探讨联合检测甲胎蛋白(AFP)和癌胚抗原(CEA)对原发性肝癌、转移性肝癌、肝硬化和病毒性肝炎的鉴别诊断价值。方法用时间分辨荧光免疫分析法检测220例各类肝病(76例原发性肝癌,25例转移性肝癌,37例肝硬化,82例病毒性肝炎)和50例健康对照者血清AFP和CEA。结果原发性肝癌组AFP极度增高,达(2984.6±4783.5)μg/L,肝硬化组AFP中度增高,为(121.6±223.5)μg/L,病毒性肝炎组和转移性肝癌组AFP均轻度增高,分别为(32.2±49.6)μg/L和(28.2±81.3)μg/L。以AFP>500.0μg/L作为界值诊断原发性肝癌的灵敏度为76.3%,特异性达99.3%。CEA以转移性肝癌组最高,为(86.3±172.6)μg/L,明显比原发性肝癌、肝硬化、病毒性肝炎和健康对照组高,差异有统计学意义(P<0.01)。结论联合检测AFP和CEA对原发性肝癌、转移性肝癌、肝硬化和病毒性肝炎有良好的鉴别诊断价值。更多还原

【Abstract】 Objective To study the clinical value of combined determination of alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA) in differential diagnosis of primary hepatic carcinoma (PHC),metastatic hepatic carcinoma (MHC),cirrhosis and viral hepatitis.Methods The serum levels of AFP and CEA in 220 patients with liver diseases (76 cases of PHC,25 cases of MHC,37 cases of cirrhosis,and 82 cases of viral hepatitis) and 50 healthy controls were measured by applying time-resolved fluoroimmunoassay (TRFIA).Results The study revealed that patients with PHC had a extremely higher level of AFP (2 984.6±4 783.5)μg/L,while the concentration of AFP in cirrhosis group displayed a moderate elevation (121.6±223.5)μg/L and both viral hepatitis group and MHC group had slight elevation of AFP (32.2±49.6)μg/L,(28.2±81.3)μg/L,respectively).With 500.0 μg/L as cut off value of AFP,the sensitivity and specificity of diagnosing PHC was 76.3% and 99.3%,respectively.The CEA level of metastatic hepatic carcinoma group was the highest (86.3±172.6)μg/L,significantly higher than that of PHC group,cirrhosis group,cirrhosis group and healthy control group (P<0.01).Conclusion Combined determination of AFP and CEA contributes to the differential diagnosis of primary hepatic carcinoma (PHC),metastatic hepatic carcinoma (MHC),cirrhosis and viral hepatitis.更多还原